Ann Arbor Times

Fifty years of economic shifts in the United States have significantly affected health outcomes, particularly for less-educated Americans, a new study reports. Published in the journal Epidemiology, the research highlights a connection between long-term economic distress and growing educational inequity in life expectancy, with adverse effects on health and lifespan for those with lower educational attainments.

Led by Arline Geronimus, professor at the University of Michigan School of Public Health and a National Academy of Medicine member, the study examined the relationship between macroeconomic restructuring and educational inequalities in health outcomes. "These findings suggest that structural economic changes over the past half-century have had profound, long-term effects on health—especially for less-educated workers," the authors noted.

Using data from 1990 to 2017, the study revealed that individuals in economically stagnant areas faced more stress and greater levels of chronic illness, leading to a reduction in life expectancy by 1-2 years among adults aged 25 to 84, compared to those in more prosperous regions. Economic factors such as job loss, reduced security, and challenges from globalization and technological advances have contributed to these disparities.

Geronimus explained that less-educated individuals have faced challenges in making ends meet, avoiding food insecurity, and accessing healthcare since 1980. This has led to high-effort adaptive coping strategies, which, though intended to overcome economic uncertainty, result in increased risks of cardiometabolic diseases and cancers due to prolonged stress.

The study also addressed misconceptions about the factors driving mortality differences, noting that the life expectancy gap is more closely linked to diseases associated with chronic stress than to deaths from suicide or substance abuse. "It is important to recognize that such findings do not diminish the importance and devastation of the opioid epidemic in 21st-century America or our need to address it," Geronimus added.

The research team highlighted the need for societal measures to address chronic disease mortality, suggesting that policymakers should be aware of the health impacts stemming from large economic shifts.

The study includes contributions from Timothy Waidmann and Vincent Pancini of the Urban Institute, John Bound of the University of Michigan and the National Bureau of Economic Research, and Meifeng Yang of the University of Michigan.